Overview of the DSM-5TM medical classification system for ADHD

A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development:1

For children, six or more of the symptoms (Table) have persisted for at least 6 months to a degree that is inconsistent with developmental level, and that negatively impacts directly on social and academic/occupational activities. Please note: the symptoms are not solely a manifestation of oppositional behaviour, defiance, hostility or failure to understand tasks or instructions1

For older adolescents and adults (age 17 and older), five or more symptoms are required (Table)1

Several inattentive or hyperactive-impulsive symptoms present prior to age 12 years1

Several inattentive or hyperactive-impulsive symptoms present in two or more settings (e.g. at home, school or work; with friends or relatives; in other activities)1

Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, and are not better explained by another mental disorder (e.g. mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).1

Furthermore, the DSM-5TM also states that it must be specified whether the individual with ADHD is in ‘partial remission’ (when partial ADHD criteria have been met for the past 6 months with full criteria met previously, and the symptoms still result in impairment in social, academic or occupational functioning)1 and the current severity of the disease.1

The current severity of ADHD should also be specified:1

Mild – few, if any, symptoms in excess of those required to make the diagnosis are present, and symptoms result in no more than minor impairments in social or occupational functioning

Moderate – symptoms or functional impairment between ‘mild’ and ‘severe’ are present

Severe – many symptoms in excess of those required to make the diagnosis, or several symptoms that are particularly severe, are present; or the symptoms result in marked impairment in social or occupational functioning.

The DSM-5TM notes that although motor symptoms of hyperactivity become less obvious in adolescence and adulthood, difficulties persist with restlessness, inattention, poor planning and impulsivity. The DSM-5TM also acknowledges that a substantial proportion of children remain relatively impaired into adulthood.1